| |
404 Steve Dr Russell Springs KY 42642-4622 | |
(270) 866-3161 | |
(270) 866-3163 |
Full Name | |
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Speciality | Clinic/Center |
Location | 404 Steve Dr, Russell Springs, Kentucky |
Authorized Official Name and Position | Eric E Loy (CHIEF EXECUTICE OFFICER) |
Authorized Official Contact | 2708642889 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1080 Burkesville KY 42717-1080 Ph: (270) 864-1472 | 404 Steve Dr Russell Springs KY 42642-4622 Ph: (270) 866-3161 |
NPI Number | 1437483815 |
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Provider Enumeration Date | 10/01/2009 |
Last Update Date | 03/15/2016 |
Medicare PECOS PAC ID | 6305947789 |
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Medicare Enrollment ID | O20100503000448 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437483815 | NPI | - | NPPES |
7100017280 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Kentucky) | Primary |
Russell County Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 124 Dowell Rd, Russell Springs, KY 42642 Phone: 270-866-4141 | |
Redd Road Enterprises, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9321 Ky 80-east, Russell Springs, KY 42728 Phone: 270-385-9208 Fax: 270-385-9209 | |
Lily Creek Medical Group, Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 92 Joe T Petty Dr, Russell Springs, KY 42642 Phone: 270-866-8881 Fax: 270-866-8849 | |
John Kilgallin M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 Dowell Rd, Russell Springs, KY 42642 Phone: 270-866-3161 Fax: 270-866-3163 | |